Once These Black and LGBTQIA+ Healthcare Professionals Became Patients Everything Changed

The American healthcare system is inundated with gaps regarding the inequality of care, especially for people of color. These disparities result from systemic racism ingrained in American culture and society, which has integrated into today's healthcare system.

It is a gross misconception that Black patients are minimally active in their healthcare by choice. The current, antiquated healthcare system that American patients have access to does not meet the health needs presented by minority groups, including BIPOC and LGBTQIA+ patients.

Access to quality care is essential to better health outcomes; however, that is less attainable for many Black Americans. These individuals are often blamed for their poor health conditions and receive impersonal engagements with practitioners, a commonality in the US healthcare system.

While many African Americans receive quality care throughout their lifetimes, a recent report by Pew Research Center shows that a majority (56%) say they've had at least one of several negative experiences. Reported experiences included the need to speak up to get the proper care and being treated with less respect than other patients. This experience painfully echoes throughout the Black community.

To properly navigate the healthcare system, patients must have the ability to engage in conversations about their health and treatment plans from an informed perspective.

"Individuals who have a familiarity with the system or have a more robust educational background aren't as affected by the breaks in the system," says Dr. Ashira Blazer, Dr. Ashira Blazer, MD, MSCI Assistant Attending Physician and Assistant Professor of Medicine at Hospital for Special Surgery's Weil Cornell Medical College. "These patients may be able to engage more actively in their care. But quality education is not always available in Black and brown communities." As a result, patients who lack a clear understanding of the healthcare system may also lack the knowledge of their right to better care as a patient.

Dr. Blazer studies the biological and genetic determinants of systemic lupus erythematosus (SLE) severity in patients of African ancestry. Most recently, she became a patient in the healthcare system, navigating and sharing her infertility journey through endometriosis, hormonal therapy, and in vitro fertilization (IVF) treatments. The multidimensional experience as a Black physician and patient with health issues has afforded her a new perspective on proper and personal care.

"During my first appointment, most of the women in the waiting room with me were not Black. I read the reviews before my appointment, and they were all great. But that was not my experience as a Black patient," says Dr. Blazer. "It was impersonal but sadly, that's not an uncommon observation. In many ways, western medicine strips away the humanity to care, and that's what was missing for me."

Black, brown, and indigenous cultures historically come from people where healing is intrapersonal. A parent, grandparent, or elder in the community may be a healer.

"The idea that care should only be effective and efficient is not culturally congruent with me as a Black woman, "says Dr. Blazer. "I expect care to be healing, to fill my cup. It reminds me to ensure I am offering my patients the same respect and experience."

Facing Compounded Discrimination

Disparities in health outcomes are exacerbated for people of color who also are lesbian, gay, bisexual, or transgender. A national survey conducted by the Center for American Progress emphasizes that LGBTQIA+ people of color are more likely than white LGBTQIA+ individuals to encounter discrimination in many settings, healthcare being one.

Briana Radford is a gay, Black woman with a medical background in animal welfare and oncology and a family history of healthcare leaders and professionals in her family. She recently had an experience at a nationally recognized hospital that is far too familiar to Black and LGBTQIA+ patients.

Briana was at an appointment with her wife after experiencing the sudden onset of intense abdominal pain. The doctor treated Briana with a dismissive and disrespectful bedside manner that was only slightly adjusted when she proved to understand her diagnosis using medical terminology. "Initially, I was only offered one treatment option—surgery," says Briana. "If I didn't understand my rights to view her medical records, I would not have known to question the original diagnosis.

It was only after several requests to view her medical records that the original diagnosis was adjusted, giving Briana additional options for care. Unfortunately, this is not the case for many patients who do not have access to quality education. As such, they often struggle to understand their healthcare options, ultimately receiving inadequate care that only worsens in time. The abysmal treatment continued as Briana recalls the doctor's threatening words during the follow-up appointment, "You'll be back…begging me to fix you again."

Becoming Your Own Advocate

There must be a significant overhaul in existing policies and programs to better align measurements and resources with the needs of the underrepresented populations. While progression is slowly underway, patients can become active and influential advocates for themselves and their healthcare outcomes.

When African Americans enter the healthcare system, they are often viewed differently than white patients based on unsupported myths and hidden biases resulting in an underdiagnosed or delayed treatment plan. Marcita Galindez has been a healthcare professional for nearly two decades for one of the most well-known networks in the nation.

Even with her extensive background, she had to learn how to advocate for herself after fighting for a proper diagnosis of her painful autoimmune disease for seven years. "I know my body better than any doctor ever will, so I knew when things weren't right. I studied my symptoms and worked through the healthcare system until I found a team that would listen to me and my needs, she says."

"If you can, get a second opinion for a major diagnosis," says Briana. "Speak with a specialist if possible. The message from the patient should be 'Educate me so I can be a good patient for you.'"

Dr. Blazer adds, "Ask for a patient care advocate if there's something you don't understand about your diagnosis or treatment plan."

Looking Forward

The roots of the American healthcare system must be disassembled before we can progress the agenda of diminishing racial and minority disparities. Admittedly, there is a substantial amount of work to be done and undone but there is hope for the continued improvement of diagnosis and treatment in the Black communities nationwide.

Healthcare providers have the opportunity to combat biases by interacting with a broader group of people in their circle. Like most people, physicians who aren't a part of a minority group may not interact with other people who are racially and socially different from them. They only observe patients outside of their circle in unhealthy and less optimal circumstances with limited engagement.

Many assumptions are based on generalization and theoretical ideas rather than practical or personal experience. As the interactions between patients and doctors increase, the opportunity to break down more biases and barriers across the healthcare system becomes more attainable.

There is hope for a more inclusive and catered experience for the Black community in healthcare as more data is collected about the Black patient experience and wellbeing. Be empowered by our ability to share our learnings and demand better treatment individually and as a community of powerful, educated, and worthy people.